DISCOID
LUPUS
ERYTHEMATOSUS


Traditional Treatments

  • Medical treatment for discoid lupus primarily involves the use of a variety of skin creams.
  • Sunscreens are used for protection.
  • Steroid creams can be applied to decrease inflammation.
  • Occasionally, small amounts of a steroid preparation will be injected with a needle into a specific lesion.
  • Because of their long list of side effects, steroid preparations taken by mouth are avoided.
  • Sometimes, short-term treatment with oral steroids will be used for particularly severe DLE outbreaks.
  • Medications used to treat the infectious disease malaria are often used to treat both Discoid and Systemic Lupus.


Alternative Treatments

  • Treatments for DLE include eating a healthy diet, low in red meat and dairy products and high in fish containing omega-3 fatty acids.
  • These types of fish include mackerel, sardines, and salmon.
  • Following a healthy diet is thought to decrease inflammation.
  • Dietary supplements believed to be helpful include vitamins B, C, E, and selenium.
  • Vitamin A is also recommended to improve DLE lesions.
  • Constitutional homeopathic treatment can help heal DLE as well as help to prevent it from developing into SLE.


Potential Prognosis

  • For the most part, the prognosis for people with DLE is excellent.
  • While the lesions may be cosmetically unsightly,
    they are not life threatening and
    usually do not cause a patient to change his or her lifestyle.
  • Only about 10% of patients with DLE will go on to develop SLE.
  • Recommendations for prevention of flares of DLE in patients with the disease include avoiding exposure to sun consistently using sunscreen.

discoid cheek rash chest systemic rash subacute cutaneous rash systemic facial rash discoid facial rash severe malar rash torso vasculitis
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DISCOID LUPUS AND CHILDREN

  • Discoid lupus erythematosus is a rare disease in children.

  • There are fewer than 20 cases reported in the medical literature.

  • Studies found that only 2% of discoid lupus erythematosus patients have onset of their disease in childhood, with the youngest patient reported presenting at one week of age.

  • A survey of 204 patients found that only 3 developed discoid lupus erythematosus before age 10.

  • As in the adult form of discoid lupus erythematosus, there are multiple clinical manifestations of childhood discoid lupus erythematosus.

  • The classic lesion is the discoid plaque with atrophy, follicular plugs, scale, and scarring alopecia.

  • In childhood discoid lupus erythematosus, a family history of discoid or systemic lupus erythematosus occurs in 25% of reported cases.

  • Unlike the adult form, childhood discoid lupus erythematosus does not demonstrate a female preponderance.

  • Photoexacerbation occurs in 31% of children with discoid lupus erythematosus, whereas sun exposure aggravates the disease in 60% of adults with discoid lupus erythematosus.

  • Over 30% of patients with childhood discoid lupus erythematosus develop systemic symptoms.

  • There are no reliable ways to predict which children will develop systemic disease: equal numbers of ANA-positive and ANA-negative patients progress to systemic disease.

  • Also, equal numbers of patients with localized versus disseminated lesions may develop systemic disease.

  • The treatment of childhood discoid lupus erythematosus consists primarily of controlling disease activity and preventing scars.

  • Sun protection and sun avoidance are the right stays of prevention, while potent topical glucocorticoids are used to treat active lesions.

  • In refractory cases, hydroxychloroquine, 4 to 6 mg/kg/day, has been helpful.

  • Close follow-up is mandatory to watch for signs of progression to systemic disease.